ATI RN
Population Based Health Care Questions
Question 1 of 5
When a patient diagnosed with paranoid schizophrenia was discharged from the unit 6 months ago, the plan was for him to take chlorpromazine (Thorazine), a conventional (first generation) antipsychotic medication, 300 mg po daily. He tells the nurse he stopped taking his pills after a few months because they made him feel like a 'zombie.' What other common side effects should the nurse determine if the patient experienced?
Correct Answer: B
Rationale: The correct answer is B: Sedation, tremor, and muscle stiffness. These side effects are commonly associated with conventional antipsychotic medications like chlorpromazine. Sedation is a common side effect that can make the patient feel drowsy or sluggish. Tremors are involuntary muscle movements that can affect the hands, arms, or legs. Muscle stiffness can cause rigidity and difficulty moving smoothly. These side effects are known to impact the quality of life and may contribute to the patient feeling like a 'zombie.' Choices A, C, and D are incorrect because they do not align with the common side effects of conventional antipsychotic medications. Sweating, nausea, and weight gain (Choice A) are not typical side effects of chlorpromazine. Headache, watery eyes, and runny nose (Choice C) are more commonly associated with allergies or cold symptoms rather than antipsychotic medications. Mild fever, sore throat, and skin rash (Choice D)
Question 2 of 5
A nurse is working with a perpetrator of family violence who has a long history of violent rages when frustrated, with periods of remorse after each outburst. The nurse is most likely to establish the nursing diagnosis of:
Correct Answer: C
Rationale: The correct answer is C: Ineffective coping related to poor anger management. This nursing diagnosis is appropriate because it addresses the perpetrator's inability to manage their anger effectively, leading to violent outbursts. The perpetrator's history of violent rages and subsequent remorse suggest a pattern of maladaptive coping mechanisms. This diagnosis focuses on the underlying issue of poor anger management, which is essential to address in order to prevent future acts of violence. Choices A, B, and D are incorrect: A: Risk for injury related to victim reprisal - This choice places the focus on potential harm to the victim as a result of retaliation, which is not the primary issue in this scenario. B: Risk for other-directed violence related to stress - While stress may contribute to the perpetrator's behavior, the primary issue lies in their poor anger management rather than just stress. D: Caregiver role strain related to feelings of being overwhelmed - This choice is not appropriate as it does not address the core issue of poor
Question 3 of 5
Which aspect of assessment has priority when a nurse interviews a rape victim?
Correct Answer: A
Rationale: The correct answer is A: Coping mechanisms the patient is using. This aspect has priority because it helps the nurse assess the immediate emotional and psychological impact of the trauma on the victim. Understanding coping mechanisms can guide the nurse in providing appropriate support and interventions. Choice B is incorrect as past sexual experiences are not as pertinent during the immediate assessment of a rape victim. Choice C is incorrect as assessing interpersonal relationships may not be a priority during the initial interview. Choice D is incorrect as the presence of a sexually transmitted disease is not the primary concern when assessing a rape victim.
Question 4 of 5
A friend brings a teenager to the emergency department. The friend found the patient unconscious in a bedroom at a party. Semen is observed on the patient's underclothes. Priority actions by the nurse should focus on:
Correct Answer: B
Rationale: The correct answer is B: Maintaining the patient's airway. This is the priority action because the patient is unconscious and airway patency is crucial for survival. Preserving rape evidence (A) can be important, but the patient's immediate health takes precedence. Obtaining a description of the rape (C) can wait until the patient's condition stabilizes. Determining what drugs were ingested (D) is important but secondary to ensuring the patient can breathe.
Question 5 of 5
A community health nurse is working with a family in which an elderly woman was neglected by her son and his wife. The elderly woman insists on remaining with the young couple despite the threat of future neglect. Which intervention should be given highest priority?
Correct Answer: B
Rationale: The correct answer is B because establishing family obligations, client rights, and consequences of abuse is crucial in protecting the elderly woman from neglect. By setting clear boundaries and educating the family on their responsibilities and the consequences of neglect, the nurse can help ensure the woman's safety. This intervention addresses the root cause of the issue and empowers the family to understand and fulfill their duties. Choice A is incorrect as solely focusing on decreasing caregivers' stress may not address the underlying neglect. Choice C is incorrect as educating caregivers on the aging process does not directly address the neglect issue. Choice D is incorrect as providing stress management techniques does not address the root cause of neglect or establish accountability within the family.